Clinical Efficacy Analysis Of Intervention Treatment For Patients With Atherosclerotic Renal Artery Stenosis

Objective: To assess the clinical efficacy of interventional therapy in patients with atherosclerotic renal artery stenosis (ARAS) and to analyze factors affecting its efficacy. Materials and methods: A total of 50 consecutive patients with 65 ARAS lesions were included in the study, who received percutaneous transluminal renal angioplasty (PTRA)(including Percutaneous renal artery ballon dilation and Percutaneous renal artery stenting placement). Blood pressure, administratation of antihypertensive drugs, serum creatinine and recurrent renal artery stenosis follow-up was performed at 1, 6, 12 and 24 months after interventional treatment in all patients.Results: Of the 50 patients, all were successfully followed up at 1, 6 and 12 months, but 15 lost at 24 months. The technical success rate of interventional precedure was 98%. Compared with preintervention average blood pressure, all follow-rp blood pressures were significantly decreased (P<0.05). The control rate of blood pressure (recovery+improvement) at 1, 6, 12 and 24 months after the procedure were 94%, 74%, 64% and 51%, respectively. The average number of antihypertensive drugs decreased from 3.5 to 1 at 1 months, 2 at 6 months and 3 at 12 months later, but at 24 months after the procedure the drug number increased to 3.5 again. Follow-up serum creatinine levels were not significantly different from the baseline level. At 6 months after the procedure, kidney function was improved in 12 (24%) patients, stable in 28 (56%) patients and deteriorate in 9 (18%) patients respectively; at 12 months, kidney function was stable in 39 (78%) patients and deteriorate in 11 (22%) patients; and at 24 months, kidney function was stable in 26 (74%) patients and deteriorate in 9 (26%). The recurrent stenosis rate was 6.8% at 6 months, 15% at 12 months, and 20% at 24 months.Conclusion: PTRA combined with stent placement procedure is a safe and effective treatment of ARAS, with high technical success rate and low complication rate. The interventional therapy can not only effectively control ARAS-related hypertension, but also preserve and even improve kidneyfunction.